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Biomedical subjects

P Ballanger

Publications and source records attributed to P Ballanger.

At least 19 recordsLinked to original sources
PubMed1992

[Iliac artery-ureteral fistula after aorto-iliac reconstructive surgery (apropos of 3 cases)].

The authors report 3 cases of ilio-ureteric fistulae following aorto-iliac reconstructive surgery. They also review 6 similar cases published in the worldwide literature. All of these cases have in common the appearance of a uretero-arterial fistula several years after the vascular operation on the iliac artery. The postoperative course of iliac thromboendarterectomy appears to be principally responsible, as in the 3 cases presented here, resulting in a pseudoaneurysm over the arteriotomy closure, especially as a patch angioplasty had been performed. This complication is exceptional. The diagnosis must be suspected in the case of profuse haematuria and a suggestive history and should be confirmed, when possible, by intravenous urography, retrograde ureteropyelography, arteriography, or even computed tomography. Treatment is complex and consists of a vascular and urological procedure depending on the degree of urgency and the possibilities of reconstruction.

Aged↗
PubMed1992

[Long-term prognosis of kidney cancer with vena cava thrombus. Report of 30 cases].

The authors present a retrospective analysis of 30 cases of renal cancer with vena cava thrombus with a sufficient follow-up to allow analysis of the long-term prognosis. Only three patients are still alive with a follow-up of 12, 34 and 57 months. The actuarial survival for the overall population was 55%, 37% and 22% at 1, 2 and 3 years respectively. Three essential factors influenced the prognosis of these patients: the presence of distant metastases, lymph node invasion and the highest cephalic level of extension of the thrombus. Renal cancer with vena cava thrombus without metastases and without lymph node involvement has a good prognosis (100% 2-year survival), but is very rare (4 out of 30 cases), so that renal cancer with vena cava thrombus must be considered to be a serious disease (3 survivors out of 30).

Actuarial Analysis↗
PubMed1991

[What is the role of endoscopy in the diagnosis and treatment of tumors of the upper urinary tract?].

17 patients with upper urinary tract tumours were investigated by endoscopy. 3 patients (Group I) with fibrous or fibroepithelial polyps were treated via a retrograde approach and did not develop any recurrences. 2 patients (Group II) developed unexplained haematuria: the diagnosis of high-grade carcinoma was confirmed by endoscopy and they were treated by nephroureterectomy. 12 patients (Group III) with low grade non-invasive urothelial carcinoma, in whom radical surgical was not indicated, were treated conservatively via the percutaneous (13 tumours) or retrograde (1 tumour) endoscopic approach. The local recurrence rate was 33% (4 out of 12 tumours) for a mean follow-up of 22 months. The recurrences were treated by repeated endoscopy in 3 patients, and by nephroureterectomy in 1 patient. Endoscopic treatment of upper urinary tract tumours should be reserved for benign tumours and selected cases of low-grade, non-invasive urothelial carcinoma.

Adult↗
PubMed1991

[Percutaneous colpocystopexy under endoscopic control in the treatment of female urinary incontinence: results in 33 cases].

33 female patients with urinary incontinence underwent simplified percutaneous bladder neck suspension: 21 (67%) presented with stress incontinence, had had. The mean follow-up was 13.2 months (6 to 24 months). Overall, 70% of patients were improved or cures including 80% of cases of stress incontinence. These results need to be interpreted in relation to the characteristics of this population. This technique is rapid, easy to perform and is not associated with any serious complications. It warrants a place in the range of surgical treatments for female urinary incontinence.

Adult↗
PubMed1991

[Flash antibiotic prophylaxis in endoscopic resections of the prostate: cefamandole versus ceftriaxone].

The aim of this study is to compare the efficiency of Cefamandole and Ceftriaxone in short-term antibioprophylaxis after transurethral prostatectomy. Ceftriaxone reduces significatively postoperative febrile reactions, although no difference is seen between the 2 regimens: 27% in group Cefamandole versus 18% in group Ceftriaxone. Postoperative urinary tract infections do not depend neither on time resection nor on weight of resected tissues. Bladder catheter removal should be treated by short-term antibiotics in order to further reduce postoperative infections.

Aged↗
PubMed1989

[Comparative study of 2 antibiotic prophylaxis regimens in endoscopic prostatic surgery].

This study compares a short antibioprophylaxis of 24 hours to a single injection treatment by cefamandole in endoscopic resection of the prostate. 122 patients were separated in two groups by randomisation. 61 patients received 1.5 g of cefamandole at induction of anaesthesia and 750 mg every six hours during 24 hours after surgery. The other 61 patients received a single injection of 1.5 g of cefamandole at the induction of anaesthesia. Both series were comparable in age, prostatic pathology, time of resection, weight to the resected prostate, the day of removal of the urinary catheter, the day of departure. In the first group, we found eight obvious infections and 10 occult infections with positive urinary microscopic examination; and in the second group, we found 11 obvious ans 4 occult infections with positive urinary microscopic examination. In both infected groups, we found mainly Pseudomonas aeruginosa. Both treatments were equally well accepted. The authors prefer the single injection treatment because of the low cost and absence of statistically significant differences between the two treatments.

Aged↗
PubMed1988

[Percutaneous treatment of tumors of the upper urinary tract].

Modern endourology procedures were used for the percutaneous conservative treatment of four tumors of the upper urinary tract in three patients, including one with a bilateral tumor, one with a single kidney and one with an abnormal contralateral kidney. No evidence of malignancy was found on the urogram, CT scan or urinary cytology; pathologic studies showed superficial low-grade lesions. Treatment was performed using a through an Amplatz sheath. Local chemotherapy with mitomycin was given postoperatively in one patient. After six months to two years follow up, no renal or vesical recurrences have been observed. With reference to this small number of cases, the usefulness of endoscopic surgery for treating tumors of the upper urinary tract is discussed. If such a procedure is feasible, patients should be carefully selected according to local conditions, tumor grade and feasibility of monitoring.

Administration, Intravesical↗
PubMed1987

[Results of the double-blind use of an alpha blockader, nicergoline, in cervico-prostatic dysfunctions].

A double-blind prospective trial investigated effects of Nicergoline on micturitional disorders in 60 selected patients with dysuria in the absence of prostate hypertrophy and neurologic disease. Results evaluated from 29 men treated with the product and 25 receiving placebo, taking into account functional improvement and urinary output variations, showed a statistically significant improvement in patients in the Nicergoline group.

Clinical Trials as Topic↗
PubMed1987

[Acquired stenosis of the upper urinary tract after percutaneous nephrolithotomy].

The authors present two well documented cases of extensive acquired stenosis of the infra-pelvic upper urinary tract following percutaneous nephrolithotomy. This type of complication appears to be exceptional as, by combining the series of two centres, it represents only two cases out of more than five hundred cases treated. The delay in appearance is of the order of six months. The more or less complex nature of the procedure does not appear to be responsible. It is difficult to determine the exact mechanism fo this complication: several hypotheses are proposed. A few rare cases have been reported in the literature without raising any particular attention. These complications required difficult reconstructive surgery with a good result in both cases. Although these complications seem to be difficult to prevent, they should be systematically detected by ultrasonography at two months and at six months to avoid delay in the diagnosis of functional renal exclusion.

Adult↗
PubMed1987

[Role of lymph node cytopuncture in the evaluation of cancers of the prostate and bladder].

Lack of reliability of lymphography and morbidity associated with lymphadenectomy lead authors to use lymph node puncture-cytology in assessment of the state of the pelvic nodes in evaluating carcinomas of the bladder and prostate. 38 patients were thus investigated (21 CA prostate and 17 bladder tumours). In 83% of cases the material collected was uninterpretable. Proof of a lymph node metastasis was obtained in 15 cases. 23 cases were further evaluated at surgery, confirming the absence of false positives. 3 false negatives would raise the question of the limitations of the method. The absence of complications would appear to justify this harmless method, with the potential of increasing its reliability by puncture of the majority of opacified nodes regardless of their radiological appearance.

Aged↗
PubMed1986

[Comparative study of cefoperazone and cotrimoxazole in kidney stone surgery via percutaneous approach].

The effectiveness and drawbacks of cefoperazone and cotrimoxazole in the prevention of postoperative infections following percutaneous removal of renal stones were studied comparatively. 60 patients were divided at random into two groups. 30 subjects were given 1 g cefoperazone IV every 8 hours for 5 consecutive days starting on the day before the procedure. The 30 other patients had an infusion of 800 mg sulfamethoxazole and 160 mg trimethoprim every 12 hours on the same 5 days. Age, sex and type of surgical procedure were comparable in both groups. Results were as follows: in the cefoperazone group, one patient had intraoperative septic shock due to a stone infected by a resistant Pseudomonas aeruginosa; in the cotrimoxazole group, 2 patients had postoperative fever due to stones infected by resistant Gram negative rods (Pseudomonas aeruginosa) and three patients had a urinary tract infection (Candida albicans in 1 case, Escherichia coli in 1 and Pseudomonas aeruginosa in 1). Tolerance was satisfactory for both regimens. The authors conclude that intravenous cefoperazone in the more effective drug and should be continued throughout the first three postoperative days.

Adolescent↗
PubMed1986

[Results of the percutaneous extraction of calculi of the kidney and ureter. Apropos of 124 cases].

In a series of 118 patients treated by percutaneous nephrolithotomy over a period of 18 months, 12 had staghorn calculi and 4 only one kidney. Punctures were made into the inferior calyx in 94% of cases. Two-plane control was by two brilliance amplifiers. The calculus had to be fragmented before removal in 53 patients. The nephrostomy catheter was left in situ for 3 days, 5 patients requiring a second operation. Results showed successful removal of calculi in 90% of cases, failure of puncture in 1.6%, the impossibility of removing calculi in 3.2% and the presence of residual calculi in 5.6%. Perforated colons in two patients healed spontaneously, two cases of secondary hemorrhage were treated by embolization and there was one death (a patient in a debilitated condition). Increasing experience in the use of the method and a more selective choice of patients should dramatically reduce the incidence of complications.

Adult↗
PubMed1986

[Emphysematous pyelonephritis. Review of the literature apropos of 4 new cases].

Based on four new cases of emphysematous pyelonephritis, the authors review a total or 59 interpretable cases of this rare disease reported in the literature. The general features of this condition are as follows: diabetic women are most frequently affected, the clinical context is generally very serious, the diagnosis is based on X-ray findings, radiating or crescent-shaped radiolucent gas images are observed with a non-functioning kidney on intravenous pyelography. CT scan was performed in two cases and confirmed the presence of air in the renal parenchyma and provided a better evaluation of the extension into the perirenal space. The only effective treatment is nephrectomy which has been able to improve the prognosis of this very serious disease, especially as the characteristic necrosis observed on histology leaves no hope of functional recovery.

Adult↗